The Association between Vitamin D and NAFLD Modified by Race Público
Ohuabunwa, Tochukwu (Summer 2020)
Published
Abstract
Non-alcoholic fatty liver disease (NAFLD) is a spectrum of metabolic irregularities that through characteristic steatosis of the liver can result in non-alcoholic steatohepatitis and cirrhosis. NAFLD has a prevalence of between 20 - 30% worldwide and is considered the most common cause of liver disease globally. Current estimates approximate the prevalence of NAFLD to be as high as between 20-34% of the U.S. population. Along with strong association with general metabolic dysfunction, evidence is mounting to suggest vitamin D deficiency (VDD) is also associated, potentially causally, with NAFLD. One of the stark gaps in the observational literature on the association between vitamin-D status and NAFLD is that few studies included racially diverse populations in spite of evidence that suggests that African-Americans may experience VDD at higher rates than their Caucasian-American counterparts. To address this research gap, we evaluated the association between vitamin D status and NAFLD and considered variation by race in a nationally representative sample of the US population. A total of 9,538 adult participants were included from the NHANES III dataset. Baseline characteristics across contingency groups of interest were compared using the chi-square tests for categorical variables and two-sample t-tests or ANOVA for continuous variables. Two‐sided P-values ≤ 0.05 were considered statistically significant. Stratified and un-stratified logistic regression models were used to assess the association between serum vitamin D level and NAFLD by race. All data were analyzed in SAS 9.4 (SAS Institute Inc., Cary, NC, USA) and R software version 4.0.1. Overall, compared to those in the lowest quintile of vitamin D, those in the highest quintile were approximately 36% less at risk for NAFLD (OR=0.641; 95% CI 0.463-0.888). However, in multi-variable models, that effect was attenuated to marginal significance in African-Americans (p-value =0.0447), but not in Mexican-Americans (p-value<0.001) and white-Americans (p-value<0.01). Our study indicates that overall, serum vitamin D level was weakly inversely associated with odds of NAFLD; however, differences in the strength of association were observed by racial group. It may not be effective to use vitamin D alone as a therapy for NAFLD. Clinicians might consider focusing on BMI and other metabolic irregularities.
Table of Contents
Contents Page
Background………………………………………………………..………………………………………..…6
Methods………………………………………………………………………………..…………..……….......7
Results……………………………………………………………………………………………………..…… 11
Discussion………………………………………………………………………………..…………………… 13
References………………………………………………………………………………………………….…. 16
Tables……………………………………………………………………………………………………….……20
Appendix 1: Supplemental Table..…………….……………………………………………………......24
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